Risk of Malnutrition Is an Independent Predictor of Mortality, Length of Hospital Stay, and Hospitalization Costs in Stroke Patients

Gomes, Filomena; Emery, Peter W.; Weekes, Elizabeth

doi:10.1016/j.jstrokecerebrovasdis.2015.12.017

Cited by 156 publications

(141 citation statements)

References 22 publications

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“…Several hypotheses have been proposed. First, a possible reason for the link between lower magnesium and in-hospital mortality is that lower magnesium at admission might reflect high BP [22,23], high blood glucose [24,25], severe state of malnutrition [26], and severe renal disease [27], which are known predictors of poor outcome and mortality of stroke in previous studies [28,29,30,31,32,33]. Second, previous animal studies indicated that magnesium could improve the blood flow in the ischemic area of the brain and enhance recovery of cellular energy metabolism after ischemia [34,35].…”

Section: Discussionmentioning

confidence: 99%

Admission Low Magnesium Level Is Associated with In-Hospital Mortality in Acute Ischemic Stroke Patients

You

Zhong²,

Du³

et al. 2017

Cerebrovasc Dis

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Background: Low magnesium levels are associated with an elevated risk of stroke. In this study, we investigated the association between magnesium levels on hospital admission and in-hospital mortality in acute ischemic stroke (AIS) patients. Methods: A total of 2,485 AIS patients, enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city, were included in this study. The patients were divided into 4 groups according to their level of admission magnesium: Q1 (<0.82 mmol/L), Q2 (0.82-0.89 mmol/L), Q3 (0.89-0.98 mmol/L), and Q4 (≥0.98 mmol/L). Cox proportional hazard model was used to estimate the effect of magnesium on all-cause in-hospital mortality in AIS patients. Results: During hospitalization, 92 patients (3.7%) died from all causes. The lowest serum magnesium level (Q1) was associated with a 2.66-fold increase in the risk of in-hospital mortality in comparison to Q4 (hazard ratio [HR] 2.66; 95% CI 1.55-4.56; p-trend < 0.001). After adjusting for age, sex, time from onset to hospital admission, baseline National Institutes of Health Stroke Scale score, and other potential covariates, HR for Q1 was 2.03 (95% CI 1.11-3.70; p-trend = 0.014). Sensitivity and subgroup analyses further confirmed a significant association between lower magnesium levels and a high risk of in-hospital mortality. Conclusions: Decreased serum magnesium levels at admission were independently associated with in-hospital mortality in AIS patients.

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Section: Discussionmentioning

confidence: 99%

Admission Low Magnesium Level Is Associated with In-Hospital Mortality in Acute Ischemic Stroke Patients

You

Zhong²,

Du³

et al. 2017

Cerebrovasc Dis

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“…The association between malnutrition and poor clinical outcomes has been established in previous medical studies [20] , and studies have shown that the median hospitalization time increases when patients are malnourished (NRS 2002 score ≥ 3) [21] . In our study, the total hospital LOS was significantly associated with hospital unit (p = 0.000), nutrition status (p = 0.000), and selfrated health (p = 0.000).…”

Section: Prolonged Hospital Staymentioning

confidence: 93%

Nutrition Status, Nutrition Support Therapy, and Food Intake are Related to Prolonged Hospital Stays in China: Results from the NutritionDay 2015 Survey

Zheng

Huang²,

Shi³

et al. 2016

Ann Nutr Metab

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Background and Aims: Malnutrition is a common and critical problem that greatly influences the clinical outcomes of hospitalized patients. Nutrition support therapy and food intake, in addition to disease-related factors, are also important to maintain the nutrition status of patients. In light of this, we aimed to examine the risk factors associated with malnutrition in 3 hospitals in China. Methods: This project was part of the NutritionDay audit, an international daylong cross-sectional audit investigating the nutritional intervention profiles of hospitalized patients. Seven standardized questionnaires were used, and malnutrition was defined as a body mass index <18.5 kg/m² or unintentional weight loss >5% in last 3 months. Results: A total of 842 hospitalized patients from 9 units in 3 Chinese hospitals participated in the project on November 19, 2015. Among them, 825 were included in the analyses. Malnutrition was identified in 29.3% of the patients and oral nutrition was the primary nutrition support therapy administered (n = 623, 75.6%). Age, nutrition support, and food intake during the past week were independent risk factors for malnutrition. Furthermore, nutrition status, nutrition support therapy, and food intake during the past week were associated with prolonged length of stay. Conclusions: The prevalence of malnutrition in Chinese hospitals was similar to that in European hospitals. Nutrition status was associated with age, nutrition support, and food intake, which was closely related to patients' clinical outcome, such as prolonged hospital stays as confirmed in this study. More studies are needed to determine why nutrition intake is often inadequate and to determine efficient methods for correcting the nutrition status of patients.

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“…In a recent study in two stroke units in south London, the use of a validated nutrition screening tool, i.e. the Malnutrition Universal Screening Tool (MUST), suggested around 30 % patients are at medium or high risk of malnutrition on admission to hospital following an acute stroke [ 26 ].…”

Section: Epidemiologymentioning

confidence: 99%

“…In a study of 537 patients screened using MUST within 72 h of hospital admission for acute stroke, there was a strong positive correlation between risk of malnutrition and mortality rate which remained signifi cant after adjustment for possible confounders [ 26 ]. At 6 months those patients who were at high risk of malnutrition on admission to hospital were twice as likely to die than those at low risk.…”

Section: Detectionmentioning

confidence: 99%

Swallowing and Nutritional Complications

Smithard

Weekes

2015

Management of Post-Stroke Complications

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Malnutrition and dysphagia are common after stroke and frequently occur together. Failure to recognise their presence and manage them effectively will result in increased morbidity and mortality. Infection risk may be raised, recovery and rehabilitation will be slowed, and people will be more likely to end up in longterm care. Treatment of malnutrition and swallowing diffi culties requires early recognition, e.g. through routine screening procedures, and their management requires input from the multi-disciplinary team.Monitoring of nutrition and swallowing status needs to be regular and consistent and may need to continue beyond hospital discharge into the care home environment and in those living at home. Consequently, issues around the detection and management of malnutrition and dysphagia need to be raised with all care staff and professionals.

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Risk of Malnutrition Is an Independent Predictor of Mortality, Length of Hospital Stay, and Hospitalization Costs in Stroke Patients

Abstract: Background

Cited by 156 publications

References 22 publications

Admission Low Magnesium Level Is Associated with In-Hospital Mortality in Acute Ischemic Stroke Patients

Admission Low Magnesium Level Is Associated with In-Hospital Mortality in Acute Ischemic Stroke Patients

Nutrition Status, Nutrition Support Therapy, and Food Intake are Related to Prolonged Hospital Stays in China: Results from the NutritionDay 2015 Survey

Swallowing and Nutritional Complications

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